Study finds comparable cardiovascular risk between JAKi and anti-TNFs in IBD

Research presented at the American College of Gastroenterology (ACG) 2024 Annual Scientific Meeting found no difference in the risk of major adverse cardiovascular events (MACE) or venous thromboembolism (VTE) between patients with inflammatory bowel disease (IBD) treated with Janus kinase inhibitors (JAKi) and those receiving anti-tumor necrosis factor (anti-TNF) therapy over a 12 month period.¹

Patients with IBD face an elevated risk of MACE,² raising safety concerns about treatment options. While JAKi are increasingly used to manage IBD, questions remain about their impact on the risk of MACE and VTE.

In this retrospective cohort study, Dr. Saqr Alsakarneh (University of Missouri-Kansas City School of Medicine) and colleagues analyzed data from the TriNetX database, focusing on 7,480 adult patients with IBD who were treated with either JAKi or anti-TNF therapy. Patients in the JAKi cohort (n=3,740) were matched 1:1 with those in the anti-TNF cohort (n=3,740) based on baseline characteristics.

Over a one-year period, 1.76% of patients in the JAKi group experienced MACE compared to 1.94% in the anti-TNF group, with no statistically significant difference (adjusted HR: 0.99; 95% CI: 0.69–1.42). Similarly, VTE rates were comparable between the groups (adjusted HR: 0.9; 95% CI: 0.61–1.32). In those patients aged 65 and older, MACE occurred in 5.3% of the JAKi group versus 6.4% of the anti-TNF group, again showing no significant difference (adjusted HR: 0.83; 95% CI: 0.49–1.42).

The researchers also performed additional subgroup analyses based on age, sex and IBD type. The results from this showed no significant differences by type of IBD (ulcerative colitis vs. Crohn’s disease), specific JAK inhibitors (upadacitinib vs. tofacitinib), or when comparing JAKi to the anti-TNF treatment, infliximab.

Although further prospective studies are needed to confirm these findings and provide additional long-term safety data, the researchers concluded that patients treated with JAKi are at no increased risk of MACE or VTE compared to those receiving anti-TNF therapy, including older adults and those aged ≥65 years. They hope these findings will assist clinicians when considering JAKi for their patients with IBD.

References:

1. Alsakarneh S, et al. Major adverse cardiovascular events in patients with IBD taking anti-TNF vs. JAK inhibitors: A propensity matched cohort analysis. Presented at: ACG Annual Scientific Meeting; Oct. 25-30, 2024; Philadelphia (hybrid meeting).
2. Sinh P, Cross RK. Cardiovascular Comorbidities and Inflammatory Bowel Disease: Causes and Consequences. Gastroenterol Hepatol (N Y). 2024 Apr;20(4):204-215. PMID: 38682122; PMCID: PMC11047149.

Disclosure: This article was created by the touchIMMUNOLOGY team utilizing AI as an editorial tool (ChatGPT (GPT-4o) [Large language model]. https://chat.openai.com/chat.) The content was developed and edited by human editors. No funding was received in the publication of this article.